Cited by 408Machine Learning in HealthcareBiomedical Text Mining and OntologiesTopic Modeling

Natural language processing in electronic health records in relation to healthcare decision-making: a systematic review

Hossain, Elias, Rana, Rajib, Higgins, Niall, Soar, Jeffrey, Barua, Prabal Datta, Pisani, Anthony R., Turner, Kathryn·2023·Computers in Biology and Medicine

Abstract

Background Natural Language Processing (NLP) is widely used to extract clinical insights from Electronic Health Records (EHRs). However, the lack of annotated data, automated tools, and other challenges hinder the full utilisation of NLP for EHRs. Various Machine Learning (ML), Deep Learning (DL) and NLP techniques are studied and compared to understand the limitations and opportunities in this space comprehensively. Methodology After screening 261 articles from 11 databases, we included 127 papers for full-text review covering seven categories of articles: (1) medical note classification, (2) clinical entity recognition, (3) text summarisation, (4) deep learning (DL) and transfer learning architecture, (5) information extraction, (6) Medical language translation and (7) other NLP applications. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result and discussion EHR was the most commonly used data type among the selected articles, and the datasets were primarily unstructured. Various ML and DL methods were used, with prediction or classification being the most common application of ML or DL. The most common use cases were: the International Classification of Diseases, Ninth Revision (ICD-9) classification, clinical note analysis, and named entity recognition (NER) for clinical descriptions and research on psychiatric disorders. Conclusion We find that the adopted ML models were not adequately assessed. In addition, the data imbalance problem is quite important, yet we must find techniques to address this underlining problem. Future studies should address key limitations in studies, primarily identifying Lupus Nephritis, Suicide Attempts, perinatal self-harmed and ICD-9 classification.

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Crossref · 10.1016/j.compbiomed.2023.106649

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  • NLP techniques such as named entity recognition, text classification, and relation extraction are used to analyze clinical reports.

    “To address this, natural language processing (NLP) techniques such as named entity recognition (NER), text classification, and relation extraction are used [38].”

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Authors
Hossain, E., Rana, R., Higgins, N., Soar, J., Barua, P. D., Pisani, A. R., & Turner, K.
Affiliations
  • North South University (BD)
  • University of Southern Queensland (AU)
  • Queensland University of Technology (AU)
  • University of Rochester Medicine (US)
Corresponding author
Hossain, Elias
Venue
Computers in Biology and Medicine
Publisher
Elsevier BV
Published
2023-03
Volume
155
Pages
106649
ISSN
0010-4825 (ISSN-L)
OpenAlex
W4319985906
Cited by
407
References
161
Citations by year
2026: 103 · 2025: 177 · 2024: 105 · 2023: 22
FWCI
8.55
Type
journal article
Language
en
Open access
closed
Locations
  • Computers in Biology and Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institutes of Health
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Biomedical Text Mining and Ontologies
  • Physical Sciences › Computer Science › Artificial Intelligence › Topic Modeling
Keywords
natural language processing, electronic health records, healthcare decision-making, named entity recognition, clinical information extraction, ICD-9, transfer learning, class imbalance, clinical text
MeSH terms
Machine Learning, Delivery of Health Care, Humans, Natural Language Processing, Information Storage and Retrieval, Electronic Health Records

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